Standard Financial Statement For Slot Machine Route Operator Licensees Form. This is a Nevada form and can be used in Tax And License Division Nevada Gaming Commission And State Gaming Contol Board Statewide .

(NGC-17A)(Rev. 6-94) STATE OF NEVADA GAMING CONTROL BOARD TAX AND LICENSE DIVISION 1919 College Parkway, P.O. Box 8004, Carson City, NV 89702 (775) 684 - 7770 555 E. Washington Ave., Suite 2300, Las Vegas, NV 89101 (702) 486 - 2008 STANDARD FINANCIAL STATEMENTS FOR FISCAL YEAR ENDED: JUNE 30, 2010 FOR SLOT MACHINE ROUTE OPERATOR LICENSEES FILING DEADLINE: September 15, 2010_ Authority: NRS Chapter 463 and NGC-GCB Regulation 6 American LegalNet, Inc. www.FormsWorkFlow.com STATE GAMING CONTROL BOARD STANDARD FINANCIAL STATEMENTS for SLOT ROUTE OPERATORS GENERAL INSTRUCTIONS 1. 2. Monetary amounts are to be rounded to the nearest dollar. Allocations should be based on the number of slot machines if specific expenses can not be identified between the different types of route operations. Between route and non-route operations any reasonable method of allocation can be used as long as it is supported by the appropriate detail for examination by Board auditors. BALANCE SHEET 3. 4. Cash includes all of the slot operator's coin in slot machine hoppers. Bucket sales - notes receivable includes all sales of slot machines where payments toward the purchase of slot machines are made through slot participation agreements. Prepaid space lease obligations include all payments of rents made in advance to satisfy future space lease commitments. Location acquisition costs include incentive payments or other lump sum disbursements made to third parties in connection with the acquisition of a route location. Contract acquisition costs include lump sum payments to obtain management rights at route locations from another slot route operator (SRO). Equipment under capital lease and Capital lease obligations include all capital lease commitments for equipment (including gaming devices), vehicles, buildings, etc. Other long-term liabilities should include deferred income taxes. 5. 6. 7. 8. 9. INCOME STATEMENT 10. 11. Complimentaries are to be reported at the rate the locations are reimbursed by the route operator. Location revenue share is the percentage of gaming win paid to locations, not including slot space lease payments. NOTE: One hundred percent of slot machine revenue is to be reported as win in these statements. Bucket sales are not deducted in the calculation of win. Rent includes those payments made toward office rent. This classification does not include space lease payments, which should be included under space lease expenses. In some locations one slot route operator may be the owner of the location or may have space lease rights to the location ("the primary operator"), but a secondary slot route operator is responsible for the drops, fills, jackpots, machine maintenance, etc. (i.e., there is both a SRO participation and a space lease at one location). The secondary SRO may receive either a percentage of win or a fixed fee for the services provided under the participation agreement. Whether the secondary SRO receives a percentage split or a fixed fee, this SRO should treat this operation as a routine participation location for reporting purposes. The results of operations should be included on schedules B-2 or B-4 as applicable. The primary SRO should report only their share of win under participation win on schedules B-1 or B-3. The primary SRO should show no drop, jackpots, or fills in these statements. Interest income and other non-operating income on Schedule B includes interest income, dividends, investment income, etc. Slot route revenues for Schedules B-1 through B-4 should generally be the same as those reported on the NGC-36 forms (NGC 34 forms for periods prior to July 1991). Questions regarding these statements should be directed to: GAMING CONTROL BOARD TAX AND LICENSE DIVISION 1919 College Parkway, P.O. Box 8004, Carson City, NV 89702-8004 (775) 684 - 7770 12. 13. 14. 15. 16. American LegalNet, Inc. www.FormsWorkFlow.com STATE GAMING CONTROL BOARD STANDARD FINANCIAL STATEMENTS FOR SLOT ROUTE OPERATORS QUESTIONNAIRE 1. If these statements cover a period of less than one year, list the starting date , and ending date , 2. This report was prepared by the: Cash Method for gaming, accrual method for other than gaming Cash Method Accrual Method Other (describe) 3. To whom should inquiries for additional information be directed? Name: Position with Business: Address: City: Telephone: Area Code 4. Independent accountants: Firm Name: Individuals Name: Position with Firm: Address: City: Telephone: Area Code State: Number: Yes No Zip: State: Number: Zip: 5. Did your CPA prepare or review these financial statements? 6. I, the undersigned, certify that, to the best of my knowledge and belief, these Standard Financial Statements are correct and complete; and that the records and methods of operation, upon which the statements are based, are maintained in accordance with the regulations of the State Gaming Control Board and the Nevada Gaming Commission. Name (type or print ) Title (type or print ) Signature (Controller or other corporation officer or owner) [1] American LegalNet, Inc. www.FormsWorkFlow.com STATE GAMING CONTROL BOARD STANDARD FINANCIAL STATEMENTS FOR SLOT ROUTE OPERATORS SCHEDULE A BALANCE SHEET ASSETS (Round Amounts to the Nearest Dollar) CURRENT ASSETS Slot Route Operations Non-Slot Route Operations Combined Total Cash......................................................... Short term investments........................... Receivables: Accounts receivable............................. Bad debt allowance........................................ ( Current portion of notes receivable - loans to licensees....... Bad debt allowance..................... ( Current portion of notes receivable - bucket sales.................... Bad debt allowance................... ( Current portion of notes receivable - other............................... Bad debt allowance................... ( Inventories: Slot machines - work in progress and finished goods........................ N/A Spare parts............................................. Other inventories................................. Prepaid expenses............................................... Other current assets................................ TOTAL CURRENT ASSETS.......... NONCURRENT ASSETS Property and equipment: Land.................................................... Building & improvements................. Furniture, fixtures & equipment..... Equipment under capital lease........ Gaming & casino operations equipment...........